A 61-Year-Old Man Arrives at the Emergency Room After Experiencing

A 61-year-old man arrives at the emergency room after experiencing fever, chills, and a productive cough with thick, blood-tinged sputum for several days. His temperature is 38.8 degrees Celsius (102 degrees Fahrenheit) , his blood pressure is 90/60 mm Hg, and his pulse rate is 110 beats per minute. On examination, the patient appears lethargic and ill. The right lung has bronchial breath sounds and crackles. Klebsiella pneumoniae grows in blood and sputum cultures. The bacteria are found to express a lipopolysaccharide on their outer membrane surface, which stimulates toll-like receptors in inflammatory cells. This, in turn, causes the IB inhibitor protein to degrade, which normally binds to a latent transcription factor found in the cytoplasm. Which of the following factors is most likely to be directly activated by the removal of this inhibitor protein?

A) Granulocyte colony-stimulating factor
B) Janus kinase 2
C) Nuclear factor-kappa B
D) Transforming growth factor-Beta
E) Tumor necrosis factor-alpha

Correct Answer:

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